British Health-Care: Stick to the Budget, No Matter Who It Kills

May 27, 2009 (LPAC)—"We should have a consistent rule that says what will be funded [by the government] and what won't. It shouldn't be a question of, who shouts the loudest."

That statement comes from London School of Economics economist Julian LeGrand, who worries that the authority of Britain's National Institute of Health and Clinical Excellence (NICE), the entity that decides what medical care or drugs get funded by the government, is being undermined "by constant challenges to its decisions." Imagine, there are people in Britain who demand the right to decent health-care, or life-prolonging drugs.

But they have to contend with NICE, whose Malthusian character has been praised by the fascist economists devising Barack Obama's health-care policies. In its Health section today, the Washington Post notes that as more costly, life-extending drugs are developed, NICE "will face more tough decisions of its own. NICE acts as a kind of budgetary police...its recommendations are almost always adopted by the government."

Because physicians and patients have challenged NICE's barbaric cost-cutting practices, it has been forced to approve use of certain expensive cancer drugs, for example, but only with stringent conditions attached. In the case of the cancer drug Sutent, NICE demanded proof that it would extend life by at least three months, and be used for illnesses that affect fewer than 7,000 new patient a year. That means it won't cover people with less rare diseases, such as breast cancer or heart disease.

"We have a finite pot of money," says NICE Chairman Michael Rawlins.

This is the system Peter Orszag's crew want to see implemented in the U.S. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society told the Post that "these new cancer drugs are incredibly expensive, and the risks and benefits need to be weighed carefully.... We are far behind the U.K. when it comes to deciding what will be paid for by the government in health care. For us, cost-effectiveness doesn't enter into the discussion. Maybe it should."